Asian Cardiovasc Thorac Ann 2006;14:263
© 2006 Asia Publishing EXchange Ltd
IMAGES IN CARDIOTHORACIC MEDICINE AND SURGERY |
Congenital Kinking of Aortic Arch Associated with Thoracic Aortic Aneurysm
Satoru Tobinaga, MD,
Hidetoshi Akashi, MD,
Teiji Okazaki, MD,
Kenji Ishihara, MD,
Kei-ichi Akaiwa, MD,
Shigeaki Aoyagi, MD
The Department of Surgery, Kurume University School of Medicine, Kurume, Japan
For reprint information contact: Satoru Tobinaga, MD Tel: 81 942 353 311 Fax: 81 942 358 967 Email:satoru{at}med.kurume-u.ac.jp, The Department of Surgery, Kurume University School of Medicine 67 Asahi-machi, Kurume 830-0011, Japan.
A 50-year-old man was referred to our hospital for surgical treatment of a thoracic aortic aneurysm (TAA). Prior to this admission, widening of the upper mediastinum was discovered on his chest roentgenogram (Fig.1
), and he was diagnosed as congenital kinking of aortic arch associated with TAA by aortography (Fig.2).
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Figure 2. The aortography shows distal aortic arch coincidental saccular and fusiform aneurysm with kinking of aortic arch (black arrow).
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At operation, the portion of the distal aortic arch to proximal descending aorta was remarkably kinked and elongated for left upward, forming an aneurysm that reached 60 mm in length. The left subclavian artery and left carotid artery were widely separated. Under the femoro-femoral bypass, we performed thoracic aortic replacement and reconstruction of the left subclavian artery with one branched 20 mm Dacron graft. The pathological examination of the resected aorta showed a cystic medial necrosis.
